Outcomes of perforated appendicitis in obese and nonobese children

Introduction: Despite abundant data on the impact of obesity in adults, little data exist that examine the impact of obesity on surgical outcomes in children. Therefore, we analyzed the impact of obesity on children with perforated appendicitis. Methods: We analyzed data from 3 prospective trials on perforated appendicitis between 2005 and 2009. Perforation was defined as a hole in the appendix or fecalith in the abdomen. There was no difference in abscess rate in the 6 arms of these trials. Body mass index (BMI) was calculated, and BMI percentile was identified according to sex and age. The obese group was defined as BMI greater than 95th percentile. Data were compared between nonobese and obese patients. Results: There were 220 patients, of which 37 patients were obese. The obese group was older with no other differences in presentation. Mean length of stay was 7.9 days in the obese patients compared with 5.8 days for the nonobese (P < .001). Mean operative time was 55.2 minutes in obese patients compared with 43.6 for nonobese (P = .003). Abscess rate was 35% in obese patients compared with 15% for nonobese (P = .01). Conclusions: Obese children undergoing laparoscopic appendectomy for perforated appendicitis experience longer operative times and suffer worse outcomes. (C) 2011 Elsevier Inc. All rights reserved.